640 likes | 1.09k Views
Introduction. 1994 140,000 U.S. children under the age of 15 had adenoidectomies and 286,000 had adenotonsillectomiesThis is down from a peak of over 1 million in the 1970'sThese are the most common major surgical procedures in children.. History. Celsus first described tonsillectomy in 30 A.D.Pa
E N D
1. The Tonsils and Adenoids in Pediatric Patients Gordon Shields, MD
Ronald Deskin, MD
June 19, 2002
UTMB
2. Introduction 1994 140,000 U.S. children under the age of 15 had adenoidectomies and 286,000 had adenotonsillectomies
This is down from a peak of over 1 million in the 1970s
These are the most common major surgical procedures in children.
3. History Celsus first described tonsillectomy in 30 A.D.
Paul of Aegina wrote his description in 625 A.D.
1867 Wilhelm Meyer reports removal of adenoid vegetations through the nose with a ring knife.
1917 Samuel J. Crowe published his report on 1000 tonsillectomies, used Crowe-Davis mouth gag
Part of Waldeyers ring after the German anatomist who described them
4. Embryology Adenoids begin forming in 3rd month of fetal development
Glandular primordia on posterior pharynx are infiltrated by lymphocytes.
Covered by pseudostratified ciliated epithelium
Fully formed by 7 month
5. Palatine tonsils begin development in 3rd month of fetal development
From ventral second pharyngeal pouches
8-10 buds of epithelium grow into pharyngeal walls, form crypts
Lymphocytes infiltrate
Branching of crypts occurs last trimester
6. Anatomy of the adenoids Single pyramidal mass of tissue based on posterior-superior nasopharynx
Surface folded without true crypts
Blood supply ascending palatine branch of facial artery, ascending pharyngeal artery, pharyngeal branch of internal maxillary artery
Innervation glossopharyngeal and vagus
No afferent lymphatics, efferents drain to retropharyngeal and upper deep cervical nodes